Introduction of Monkeypox into a Community and Household: Risk Factors and Zoonotic Reservoirs in the Democratic Republic of the Congo

Leisha Diane Nolen U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Lynda Osadebe U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Jacques Katomba U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Jacques Likofata U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Daniel Mukadi U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Benjamin Monroe U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Jeffrey Doty U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Lem's Kalemba U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Jean Malekani U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Joelle Kabamba U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Pierre Lokwa Bomponda U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Jules Inonga Lokota U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Marcel Pie Balilo U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Toutou Likafi U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Robert Shongo Lushima U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Jean-Jacques Muyembe Tamfum U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Emile Wemakoy Okitolonda U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Andrea M. McCollum U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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Mary G. Reynolds U.S. Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia; U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia; Minstere de la Santé, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention, Field Epidemiology Training Program, Kinshasa, The Democratic Republic of Congo; National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo; U.S. Centers for Disease Control and Prevention Kinshasa, The Democratic Republic of Congo; University of Kinshasa, Department of Biology, Kinshasa, The Democratic Republic of Congo; Minstere de la Santé, Tshuapa Health District, The Democratic Republic of Congo; Kinshasa School of Public Health, The Democratic Republic of Congo

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DOI:
https://doi.org/10.4269/ajtmh.15-0168
Volume/Issue:
Volume 93: Issue 2
Page(s):
410–415
Restricted access
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An increased incidence of monkeypox (MPX) infections in the Democratic Republic of the Congo was noted by the regional surveillance system in October 2013. Little information exists regarding how MPX is introduced into the community and the factors associated with transmission within the household. Sixty-eight wild animals were collected and tested for Orthopoxvirus. Two of three rope squirrels (Funisciurus sp.) were positive for antibodies to Orthopoxviruses; however, no increased risk was associated with the consumption or preparation of rope squirrels. A retrospective cohort investigation and a case–control investigation were performed to identify risk factors affecting the introduction of monkeypox virus (MPXV) into the community and transmission within the home. School-age males were the individuals most frequently identified as the first person infected in the household and were the group most frequently affected overall. Risk factors of acquiring MPXV in a household included sleeping in the same room or bed, or using the same plate or cup as the primary case. There was no significant risk associated with eating or processing of wild animals. Activities associated with an increased risk of MPXV transmission all have potential for virus exposure to the mucosa.

Author Notes

* Address correspondence to Leisha Diane Nolen, Bacterial Special Pathogens Branch, U.S. Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30329. E-mail: xdf8@cdc.gov

Authors' addresses: Leisha Diane Nolen, Bacterial Special Pathogens Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA, E-mail: xdf8@cdc.gov. Lynda Osadebe, Benjamin Monroe, Jeffrey Doty, Joelle Kabamba, Andrea M. McCollum, and Mary G. Reynolds, Poxvirus and Rabies Branch, U.S. Centers for Disease Control and Prevention, Atlanta, GA, E-mails: losadebe@gmail.com, ihd2@cdc.gov, uwb7@cdc.gov, jlz7@cdc.gov, azv4@cdc.gov, and nzr6@cdc.gov. Jacques Katomba and Jacques Likofata, Department of Epidemiology, Ministère de la Sante, Kinshasa, The Democratic Republic of the Congo, E-mails: jxkk2000@gmail.com and jacqueslikofata@gmail.com. Daniel Mukadi, Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Kinshasa, The Democratic Republic of the Congo, E-mail: drmukadi@gmail.com. Lem's Kalemba and Malekani Jean, Department of Biology, Université de Kinshasa, Kinshasa, The Democratic Republic of the Congo, E-mails: lemskalemba@yahoo.com and elevagefaune@yahoo.fr. Pierre Lokwa Bomponda and Jules Inonga Lokota, Ministère de la Sante, Tshuapa Health District, Tshuapa, The Democratic Republic of the Congo, E-mails: Plbompond@yahoo.fr and JuInLokoto@yahoo.fr. Marcel Pie Balilo and Toutou Likafi, Department of Hemorrhagic Fever and Monkeypox, Ministère de la Sante, Tshuapa Health District, Tshuapa, The Democratic Republic of the Congo, E-mails: marcelbalilopie@yahoo.fr and toutoulikafi@gmail.com. Robert Shongo, Ministry of Health, Surveillance, Kinshasa, The Democratic Republic of the Congo, E-mail: robert_shongo@yahoo.fr. Jean-Jacques Muyembe Tamfum, Institut National de Recherche Biomédicale, Ministry of Health, Kinshasa, The Democratic Republic of the Congo, E-mail: muyembejj@gmail.com. Emile Wemakoy Okitolonda, Center for HIV/AIDS Strategic Information, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo, E-mail: okitow@yahoo.fr.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2015
Received:
27 Feb 2015
|
Accepted:
02 Apr 2015
|
Published Online:
05 Aug 2015
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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